Studies in health technology and informatics
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This study aims to describe primary care professionals' self-reported attitudes towards evidence-based practice (EBP), attention to information sources, perceptions of the barriers to EBP and strategies to improve insight in EBP and patient care. An e-mail invitation with link to an Internet-based survey was sent to Belgian medical doctors (MDs), nurses and paramedics. Under paramedics, we've included emergency medical technicians, firemen and medical volunteers (Red Cross). ⋯ The most appropriate method for actual implementation of evidence-based practice at all levels of health care is to provide summaries of evidence, easily understandable protocols and web-based databases accessible from the working environment. Students should not only learn the skills related to EBP, but should be able to integrate knowledge effectively in the clinical setting and routine care. Above all, their supervisors themselves need to evolve from 'experience-based' to evidence-based practice'.
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Stud Health Technol Inform · Jan 2006
Information therapy: The strategic role of prescribed information in disease self-management.
Imagine this: evidence-based medical information specifically written for and prescribed to a patient with chronic illness, targeted to that patient's specific "moment in care" and designed to help that patient manage his or her illness. Imagine "information therapy" built into every clinical encounter that a patient has with a physician or other health care service. ⋯ Information therapy is a new disease management tool that provides cost-effective disease management support to a much larger portion of the chronically ill population than is generally reached. This paper is a practical presentation of information therapy, its role in predictive modeling and disease self-management, and its potential for improving the outcomes of chronic care.
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Stud Health Technol Inform · Jan 2006
Variations of the position of the cerebellar tonsil in adolescent idiopathic scoliosis with severe curves: a MRI study.
This study is an investigation into the position of the cerebellar tonsils in AIS with severe curves and any relationship it has with age, sex, curve severity and curve pattern. Sagittal magnetic resonance imaging (MRI) of hindbrain was performed on both of 205 AIS patients with a Cobb angle greater than 40 degrees and 86 healthy controls. The position of the cerebellar tonsil relative to the line connecting the basion and opisthion (BO line) was measured. ⋯ However, a significant lower incidence of tonsillar ectopia (p=0.049) was found in patients with lumbar curves when compared to those with thoracic or thoracolumbar curves. In conclusion, there was a relatively lower position of the cerebellar tonsil together with a significant higher incidence of tonsil ectopia in AIS patients. There was a trend that tonsillar ectopia was more often in thoracic or thoraco-lumbar curves, suggesting that a lower position of the cerebellar tonsil may play an important role in the etiopathogenesis of AIS.
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Stud Health Technol Inform · Jan 2006
Removal of paper-based health records from Norwegian hospitals: effects on clinical workflow.
Several Norwegian hospitals have, plan, or are in the process of removing the paper-based health record from clinical workflow. To assess the impact on usage and satisfaction of electronic health record (EHR) systems, we conducted a survey among physicians, nurses and medical secretaries at selected departments from six Norwegian hospitals. The main feature of the questionnaire is the description of a set of tasks commonly performed at hospitals, and respondents were asked to rate their usage and change of ease compared to previous routines for each tasks. ⋯ Even though the increase in use among clinicians after removing the paper based record were mainly in tasks where respondents had no choice other than use the electronic health record, the attitude towards EHR-systems were mainly positive. Thus, while removing the paper based record has yet to promote new ways of working, we see it as an important step towards the EHR system of tomorrow. Several Norwegian hospitals have shown that it is possible.